scholarly journals Comparative Analysis of Acid-base Status Parameters in Newborn with Congenital Surgical Malformations During Perioperative Care Based on Types of Anesthesia

2021 ◽  
Vol 2 ◽  
pp. 14-22
Author(s):  
Oleksii Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Oxygen Mixture ◽  
Acid Base ◽  
Group Iii ◽  
Group I ◽  
Anesthesia Group ◽  
Significant Difference ◽  
Combined Anesthesia ◽  
Acid Base Status ◽  
Group Ii

Introduction: Congenital malformations (CM) are most common in newborns and infants in the first year of life and require surgical correction in the first hours, days, months of life. Surgical interventions in severely ill babies with malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism shifts, water-electrolyte, protein, and acid-base status disorders. This study aimed to compare acid-base status in newborns and infants with congenital surgical pathology under different types of combined anesthesia.  Materials and methods: This retrospective study included 150 newborns and infants with CM who required surgery. The patients were divided into three groups based on types of provided anesthesia: inhalation by Sevoran (sevoflurane) and regional anesthesia (group I); inhalation of Sevoran and intravenous anesthesia by Fentanyl (group II); and intravenous combination of Fentanyl and 20% Sodium Oxybutyrate (group III). The analysis included: acid-base status, peripheral oximetry, and the need for an oxygen mixture inhaled by the patient. Results In group I, there was a significant reduction in partial tension of CO2 and increased pH from the pre-surgical status, at the time of induction of anesthesia, during the most painful, traumatic stage, and after surgery compared to group II and III. Peripheral O2 saturation was not critically reduced at all stages of observation except in babies of group I compared to group III at the stage of induction of anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, p = 0.0194) and at the most painful period of surgery (96.29 ± 3.47 vs. 98.10 ± 2.47, p = 0.0368). In group I, newborns and infants required higher oxygen concentrations in the inhalation mixture. There was a significant difference in FiO2 between groups I and III during the most painful stage of surgery (0.47 ± 0.29 and 0.33 ± 0.2, p = 0.0071), and immediately after surgery (0.34 ± 0, 19 and 0.26 ± 0.13, p = 0.0246). Conclusion: Among the newborns and infants with CM requiring surgical intervention and combined anesthesia, the most substantial acid-base status changes were observed in the group where anesthesia was provided by Sevoran (sevoflurane) and regional anesthesia (Group I).

scholarly journals Peculiarities of the state of peripheral oxygenation of tissues in different kinds of combined anesthesia in children with congenital surgical pathology

2021 ◽  
pp. 49-52
Author(s):  
Aleksey Vlasov
Keyword(s):  
Heart Rate ◽  
Pulse Oximetry ◽  
Regional Anesthesia ◽  
Congenital Malformations ◽  
Oxygen Deficiency ◽  
The State ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Combined Anesthesia

In the presented work, we have assessed the features of peripheral oxygenation in children with congenital malformations of the surgical profile under various types of combined anesthesia. The aim of the study. To assess the state of peripheral oxygenation in newborns and infants with congenital malformations with various types of anesthetic support. Materials and research methods. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). The parameters of pulse oximetry were analyzed: peripheral oxygenation, heart rate. Additionally, the concentration of oxygen in the respiratory mixture of children was taken into account. Research results. Peripheral saturation did not critically decrease at all stages of observation, with the exception of a decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p˂0.05, respectively) and at the most painful moment of the operation (96.29±3.47 versus 98.10±2.47, with p˂0.05). At the painful moment of the operation, it was in children of group I that a drop in heart rate was noted compared to group III (127.98±13.77 and 136.10±15.37, respectively, with p˂0.05) and group II (134.02±18.43, at p>0.05) against the background of a decrease in SpO2. Newborns and group I infants required higher oxygen concentrations in the breathing mixture. A significant difference in the indicator is noted between groups I and III at the traumatic stage – 0.47±0.29 and 0.33±0.2, with p˂0.05, respectively, and immediately after the operation – 0.34±0,19 and 0.26±0.13, with p˂0.05, respectively. Conclusions. The expediency and effectiveness of pulse oximetry for children with congenital malformations at all stages of anesthetic support during surgical treatment was confirmed. The risk group for the formation of oxygen deficiency in organs and tissues, the occurrence of pain during the operation were newborns and infants, for whom combined anesthesia was chosen in the form of an inhalation method and regional anesthesia. In the case of the appointment of this type of anesthetic support, it is necessary to more closely monitor the indicators and promptly correct the deterioration of the child's condition

scholarly journals CLINICAL ASSESSMENT OF THE ACID-BASIC STATE AND INDIVIDUAL INDICATORS IN CHILDREN WITH CONGENITAL SURGICAL PATHOLOGY UNDER DIFFERENT TYPES OF ANESTHESIA

2021 ◽  
Vol 11 (1(39)) ◽  
pp. 13-21
Author(s):  
Aleksey Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Congenital Malformations ◽  
Metabolic Disorders ◽  
Acid Base ◽  
Intravenous Anesthesia ◽  
Clinical Indicators ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Different Types

Introduction. Congenital malformations are morecommon in newborns and require surgical correction againstthe background of severe perinatal diseases, which leadsto catabolic stress, circulatory and respiratory disorders,metabolic disorders, disorders of water-electrolyte, proteinand acid-base states.Aim of the study. To establish the dynamics of acidbase status and some clinical indicators in newborns andinfants with congenital pathology under different types ofanesthesia during surgical treatment.Material and research methods. A retrospective studyincluded 150 newborns and infants with congenital malformationsof the surgical profile, depending on the anesthesia (inhalation +regional anesthesia; inhalation + intravenous anesthesia andtotal intravenous). The indicators of the acid-base state,peripheral oximetry, and the need for the oxygen mixtureinhaled by an infant were analyzed.Results. When assessing the indicators of PvCO2, pH,it was found that in group I with anesthesia accompaniedby inhalation and regional anesthesia, the partial tensionof CO2was reduced and the pH was increased at all stages.Peripheral saturation was not critically reduced during theobservation, except for the obtained decrease in children ofgroup I compared with group III at the stage of inductionof anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, at p = 0.0194,respectively). ) and at the most painful moment of surgery(96.29 ± 3.47 vs. 98.10 ± 2.47, at p = 0.0368). Newbornsand infants required higher concentrations of oxygen inthe inhalation mixture during inhalation and regionalanesthesia. There was a significant difference between theI and III groups during the most painful stage - 0.47 ± 0.29and 0.33 ± 0.2, at p = 0.0071, respectively, and immediatelyafter surgery - 0.34 ± 0, 19 and 0.26 ± 0.13, at p = 0.0246,respectively.Conclusion. Among the examined groups, the mostvulnerable to pathological changes were children whowere provided with anesthesia by inhalation sevoran withregional anesthesia.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

scholarly journals Assessment of Outcome of Intrathecal Analgesia in Multiparous Women Undergoing Vaginal Delivery

2020 ◽  
Vol 5 (1) ◽  
pp. 153-155
Author(s):  
Sanjay Melville Masih ◽  
Rakesh Kumar Gupta
Keyword(s):  
Vaginal Delivery ◽  
Group Iv ◽  
Normal Vaginal Delivery ◽  
Secondary Outcome ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Multiparous Women ◽  
Group Ii ◽  
Intrathecal Analgesia

Background: The present study was conducted to assess the outcome of intrathecal analgesia in multiparous women undergoing vaginal delivery. Subjects and Methods: The present study was conducted among 80 multiparous women ages ranged 18- 40 years. All patients received 0.5 ml of intrathecal injection of 2.5 mg bupivacaine 0.5% and 1 ml dexamethasone 4 mg plus a 0.5 ml adjuvant. The adjuvants in group I patients were 100 μg morphine, 25 μg fentanyl in group II, 5 μg dexmedetomidine in group III and normal saline in group IV (control group). The primary and secondary outcome was the duration of pain relief, the analgesia onset time, the maximum level of sensory block, the visual analogue scale (VAS) was recorded. Results: The mean duration of analgesia in group I was 182.4 minutes, in group II was 170.5 minutes, in group III was 200.4 minutes and in group, IV was 140.2 minutes. The onset of analgesia was 3.9 minutes, 2.8 minutes, 2.7 minutes and 4.5 minutes in group I, II, III and IV respectively. S1 sensory regression time (minutes) was 181.4, 157.4, 185.3 and 130.6 in group I, II, III and IV respectively. Modified Bromage scale 5 minutes, 15 minutes and 30 minutes after IT in all groups was 0.0. VAS was 1.3, 1.6, 1.6 and 3.1 with significant differences in all groups (P< 0.05). There was non- significant difference in mean age, weight, height and gestational age between all groups (P> 0.05). There was a non- significant difference in APGAR 1, 5, umbilical pH immediately after delivery, neonatal HR after 5minute, 15 minutes and 30 minutes in all groups (P> 0.05). Conclusion: The authors found that dexmedetomidine is a safe and effective adjuvant to intrathecal bupivacaine-dexamethasone in multiparous women undergoing normal vaginal delivery.

Is there a difference in prevalence of anxiety and depression symptoms among patients with different stages of hypertension?

2017 ◽  
Vol 41 (S1) ◽  
pp. S414-S414 ◽  
Author(s):  
A. Mermerelis ◽  
S.M. Kyvelou ◽  
V. Akke ◽  
C. Papageorgiou ◽  
C. Stefanadis ◽  
...  
Keyword(s):  
Depression Scale ◽  
Group Iv ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Study Cohort ◽  
Hypertensive Patients ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

IntroductionWhether anxiety and depression are associated with hypertension and to what extent is not clear.AimsThe aim of the present study was to assess any differences in the prevalence of anxiety and depression among different groups of hypertensive patients.MethodsThe study cohort comprised of 127 patients (75 male, mean age 54 ± 14) who underwent assessment of their blood pressure levels and were divided in four groups: group I (normotensives, n = 34), group II (stage 1 HTN, n = 33), group III (stage 2 HTN, n = 30) and group IV (stage 3 HTN, n = 30). The evaluation of anxiety disorder was made by means of Hospital Anxiety Depression Scale (HADS), while the evaluation of depression was made with the Beck Depression Inventory (BDI). Statistical analysis was done with SPSS for windows. P-value was set at 0.05 for differences to be considered significant.ResultsComparing the four groups of patients there was a significant difference both in BDI (8.6 ± 7.0 vs. 11.6 ± 10.4 vs. 27.1 ± 5.8 vs. 32.4 ± 3.9, P < 0.0001) and HADS (10.2 ± 7.2 vs. 9.7 ± 7.0 vs. 16 ± 4.7 vs. 27 ± 5.1, P < 0.0001). We proceeded to comparison among the 4 groups and there was a significant rise in the BDI and HADS in three of the four groups group II > group III > group IV, P < 0.0001.ConclusionThese data suggest that there is a clear burden of anxiety and depression as the levels of BP increase. This finding is of important clinical significance as it could contribute to a different approach of hypertensive patients. A larger cohort study could enlightened the mechanisms involved.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Role of sFas in the Immune Escape Mechanism and Progression of Cancer Larynx

2009 ◽  
Vol 2 ◽  
pp. CMENT.S2565
Author(s):  
Amr A El Badry ◽  
Ismail Elmofty ◽  
Amira Helmy
Keyword(s):  
Serum Level ◽  
Buffy Coat ◽  
Control Group ◽  
Group Iii ◽  
Soluble Fas ◽  
Group I ◽  
Significant Difference ◽  
Cancer Larynx ◽  
The Mean ◽  
Group Ii

This work assess serum levels of soluble Fas form (sFas) in patients with different stages of laryngeal squamous cell carcinoma(LSCC) to investigate its prognostic significance. We correlate its levels with the morphological changes of peripheral blood cells via buffy coat examinatin. The study population included 70 patients clinically diagnosed and pathohistologically confirmed LSCC in addition to 20 healthy controls. According to TNM classification 33(47.1%) patients were in stage I (group I) and 24(34.3%) in stage II (group II), 13(18.5%) in stage III (group III). The results revealed that the mean serum level of sFas (pg/ml) in the control group was 51.2, in group I was 66.33, in group II was 81.33 and in group III was 112.45. Statistical analysis of the mean of sFas by ELISA test in the patients' groups in comparison to the control revealed a significant increase of both group II and III in comparison to the control group (P < 0.01) but there was no significant difference (P > 0.05) between group I in comparison to either the control or group II. There was a significant difference (P < 0.05) between group I in comparison to group III. LM examination revealed massive extent of the apoptotic cells in group III when compared to both group I and group II. EM examination of the buffy coat revealed apoptotic changes, mainly in the peripheral blood mononuclear cells (PBMNCs), represented by surface membrane ruffles and blebs with clumped nuclear chromatin and vacuolated cytoplasm. In conclusion, this study may help us to better understand one of the escape mechanisms in cancer larynx. This mechanism is represented by the significant increase in both the serum level of sFas and the morphological apoptotic changes that detected in PBMNCs. Soluble Fas may contribute to the progression of laryngeal cancer. It can be used as an attractive target for anticancer therapy and may be considered as a marker of disease progression and poor prognosis in laryngeal cancer.

scholarly journals Different Bleeding Patterns with the Use of Levonorgestrel Intrauterine System: Are They Associated with Changes in Uterine Artery Blood Flow?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Carlo Bastianelli ◽  
Manuela Farris ◽  
Stefania Rapiti ◽  
Roberta Bruno Vecchio ◽  
Giuseppe Benagiano
Keyword(s):  
Blood Flow ◽  
Uterine Artery ◽  
Endometrial Thickness ◽  
Power Doppler ◽  
Artery Blood Flow ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Before And After ◽  
Group Ii

Objective. Evaluate if different bleeding patterns associated with the use of the levonorgestrel intrauterine system (LNG-IUS) are associated with different uterine and endometrial vascularization patterns, as evidenced by ultrasound power Doppler analysis.Methodology. A longitudinal study, with each subject acting as its own control was conducted between January 2010 and December 2012. Healthy volunteers with a history of heavy but cyclic and regular menstrual cycles were enrolled in the study. Ultrasonographic examination was performed before and after six months of LNG-IUS placement: uterine volume, endometrial thickness, and subendometrial and myometrial Doppler blood flow patterns have been evaluated.Results. A total of 32 women were enrolled out of 186 initially screened. At six months of follow-up, all subjects showed a reduction in menstrual blood loss; for analysis, they were retrospectively divided into 3 groups: normal cycling women (Group I), amenorrheic women (Group II), and women with prolonged bleedings (Group III). Intergroup analysis documented a statistically significant difference in endometrial thickness among the three groups; in addition, mean pulsatility index (PI) and resistance index (RI) in the spiral arteries were significantly lower in Group I and Group III compared to Group II. This difference persisted also when comparing—within subjects of Group III—mean PI and RI mean values before and after insertion.Conclusions. The LNG-IUS not only altered endometrial thickness, but—in women with prolonged bleedings—also significantly changed uterine artery blood flow. Further studies are needed to confirm these results and enable gynecologists to properly counsel women, improving initial continuation rates.

scholarly journals Effects of different bleaching methods on shear bond strengths of orthodontic brackets

2012 ◽  
Vol 83 (4) ◽  
pp. 686-690 ◽  
Author(s):  
Ahmet Yalcin Gungor ◽  
Erhan Ozcan ◽  
Huseyin Alkis ◽  
Hakan Turkkahraman
Keyword(s):  
Shear Bond Strength ◽  
Testing Machine ◽  
Orthodontic Brackets ◽  
Group Iii ◽  
Group I ◽  
Human Enamel ◽  
Significant Difference ◽  
Bond Strengths ◽  
Group Ii ◽  
Method Group

ABSTRACT Objective: To evaluate the effects of different bleaching methods on the shear bond strength (SBS) of orthodontic brackets. Materials and Methods: Forty-five freshly extracted premolars were randomly divided into three groups (n  =  15 per group). In group I, bleaching was performed with the office bleaching method. In group II, bleaching was performed with the home bleaching method. Group III served as the control. Orthodontic brackets were bonded with a light cure composite resin and cured with an LED light. After bonding, the SBS of the brackets were tested with a Universal testing machine. Results: Analysis of variance indicated a significant difference between groups (P &lt; .001). The highest values for SBS were measured in group III (20.99 ± 2.32 MPa). The SBS was significantly lower in groups I and II than in group III (P &lt; .001). The lowest values for SBS were measured in group II (6.42 ± 0.81 MPa). SBS was significantly higher in group I than in group II (P &lt; .001). Conclusions: Both of the bleaching methods significantly affected the SBS of orthodontic brackets on human enamel. Bleaching with the home bleaching method affected SBS more adversely than did bleaching with the office bleaching method.

scholarly journals EFFECTS OF TRAINING SIDE HOP OVER BARRIER WITH DUMBELL AND HEXAGON WITH DUMBELL ON LEG STRENGTH AND LEG POWER

2018 ◽  
Vol 2 (2) ◽  
pp. 46
Author(s):  
Nur Akbari ◽  
Oce Wiriawan ◽  
Nining Widyah Kusnanik
Keyword(s):  
Control Group ◽  
Percentage Increase ◽  
Design Data ◽  
Group Iii ◽  
Strength Group ◽  
Leg Strength ◽  
Group I ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group Ii

This study was conducted at 45 students of SMAN 1 Cerme with aged between 15-16 years old. Students were  divided into 3 groups. the type of research used quantitative with quasi-experimental approach. Instruments of this study were test of leg strength and leg power using Leg Dynamometer and  Jump MD. The research design used matching only design. Data was anlyzed using ANOVA. The results of the  research was found that training program side hop over  barrier with dumbell and hexagon with  dumbbell significantly increase at leg strength and leg power (Sig. 0.000 <α = 0.05). Group I, Group II and Group III had significant difference (Sig. 0.000 α = 0.005). Percentage increase in leg strength group 1 of 1,80% and leg  power of 15,49%. Percentage increase in leg strength group II of  1,68% and a power of 14,27% and whereas in the control group increase in leg strength was 1.67% power at 12.32%.It can be concluded that There was an increase in leg strength and leg power in each group after the training was given. In addition, there were differences among the three groups effects seen improved in leg strength and leg power through ANOVA, where the training side hop over barrier with dumbbell and hexagon with dumbell had increased in leg strength and leg   power. But side hop over barrier with dumbbell had more significant increased than hexagon with dumbbell. Key words: Side hop over with barrier dumbell,  hexagon with dumbell, leg strength and leg power.

scholarly journals Screening of anticonvulsant effect of carvedilol on electrically induced convulsions in Wistar albino rats

2020 ◽  
Vol 9 (12) ◽  
pp. 1803
Author(s):  
Biacin Babu ◽  
Madhavrao Chavan
Keyword(s):  
Albino Rats ◽  
High Dose ◽  
Anticonvulsant Effect ◽  
Low Doses ◽  
Test Drug ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Wistar Albino Rats

Background: Epilepsy is one of the major central nervous system disorders. The parent study aimed to screen the anticonvulsant effect of carvedilol on electrically induced convulsions in Wistar albino rats.Methods: This study was done in Wistar albino rats. A total of 30 rats were divided into 6 groups each of six rats. group-I (0.9% normal saline), group-II diphenylhydantoin (10 mg/kg/BW/ip), group-III carvedilol (1mg/kg/BW/PO), group-IV carvedilol (2 mg/kg/BW/PO) and group-V carvedilol (4 mg/kg/BW/PO). All the groups were administered drugs and subjected to electric shock. Scores of seizures and percentage of protection were recorded to compare between the groups. One was ANOVA (post hoc) followed by Dunnet t test applied to find the statistically significant between the groups.Results: Group-I showed significant difference compared to other groups. Group-II showed significant difference with group-III and IV not with V. High dose of test drug and standard drug showed similar results in percentage of seizures prevention. Control and low doses of test drugs showed significant difference compared to standard and high dose of test drug in seizures prevention.Conclusions: High of carvedilol showed significant seizures prevention compared to low doses and control group.

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